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Wolff Parkinson White Syndrome.

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I live in Spain (so please excuse my poor english) and I’m 67 old. I have Wolff-parkinson-white present in all EKGs since I was young. The WPW remained constant during all stress tests (Bruce protocol), with ajmaline tests and also in 24H Holter tests I had during last 30 years.
But it was so until few months ago… Suddenly the WPW disappeared, and in the last three EKGs the delta wave is gone and my EKG is absolutely normal.
My medicine doctor is confused as he says he never saw this WPW remission, he thinks it can be an intermittent WPW but, as I said, it was present in all EKGs and under all conditions for 30 years.
My question is, is it possible a spontaneous remission of WPW?
Thanks for your answer

Category: Cardiologist

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Category: Cardiologist
 22 Doctors Online


Thank you for your query at

You had preexcitation or delta waves in your ECG which has disappeared recently.
It means you had conduction over an accessory pathway all these years instead of the normal pathway through AV node.

Did you have any event like a myocardial infarction or chest pain which could have damaged the accessory pathway?
If you never had any myocardial infarction then it is a good thing that the
preexcitation has disappeared from your ECG.

In a study by Chen, chiang and tai in 1996 published in Circulation journal, over a 10 year of followup in symptomatic wpw patients with preexcitation the preexcitation disappeared in 22.5% of patients. In asymptomatic patients the chances are more. In asymptomatic patients, the capacity for antegrade conduction across the accessory pathway often decreases with age. This is probably due to fibrotic changes at the site of insertion of the accessory bypass tract. Disappearance of the delta wave with class 1a or 1c drugs (eg flecainide) or exercise also suggests low risk of sudden death.

So in a way the disappearance of the wpw associated preexcitation symbolises conduction over the normal route ie the AV node. And most probably it is a good thing to happen.

Hope this helps, please feel free to discuss further.

Dr Vivek Mahajan
DM Cardiology Fellow (PGIMER)
MD Medicine (AIIMS)

Patient replied :

Hi Vivek,
Thanks for ur rapid response.

In my case the preexcitation was asymptomatic and it didn’t disappeared with Ajamaline nor exercise as I told you in my previous message.

About infarction you mention, I’m unsure if I had any but, as a matter of fact, I went to visit my medicine doctor ‘cause I had a short episode (about 10 minutes) of [very] irritative cough just after dinner. That night I had to urinate almost every hour and and I felt so hot I was sweating all night (no fever). So much as I lost about two kilograms weight that night. No pain, no dyspnea.
In the morning I called my MD by phone to explain him the episode but he didn't give it any importance.
A bout three weeks later I felt some “air hunger” from time to time and for a week or so, only during daytime and no related to exercise.
So I went to my MD and he made an EKG, then he was so surprised by the disappearance of preexcitation being the EKG absolutely normal. I asked him if it was posible I could have a small infarction which destroyed the abnormal Kent path and he said than not because the EKG didn't show any wave typical of infarctions and the auscultation was quite normal.

Since then I had three more EKGs and all is OK

Is there any way to realize if I had an small infarction with the same effect as an RF ablation?



My apologies for the delay with the reply, owing to personal reasons.

It is difficult to say that you had a large infarction if your ecg is normal. However, given that yhe preexcitation disappeared with the so called event it could still be a small infarction. You may get a 2D echo done to look for any regional wall motion abnormality. This may possibly pick up an infarction if it has happened though am not sure that it will pick up extremely small infarction.

Anyways very small infractions shouldn't be a matter of worry except that you should follow a very healthy lifestyle to prevent future large infarction.

Hope this helps, would be glad to answer any queries.

Dr Vivek Mahajan
DM Cardiology

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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